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Deactivated NPI 1396294484 Deactivated / Inactive NPI Female Practitioner

Edith Johnson

Rehabilitation Practitioner • Reno, NV

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Edith Johnson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date September 29, 2016
NPI Deactivation Date October 30, 2025
Total Practice Duration ~9 Years of Practice (2016 – 2025)

Professional Overview & Biography Verified Profile Summary

Edith Johnson was a registered Rehabilitation Practitioner practicing in Reno, NV. Throughout an active medical career spanning 9 years, Edith Johnson provided care at the practice location at 4600 KIEZKE LANE until profile deactivation on 2025-10-30.

Practice Location & Contact Primary Location

Practice Address

4600 Kiezke Lane
O-260

Reno, NV 89502

Telephone 7758259995
Fax 7758259877
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Rehabilitation Practitioner in Reno, NV

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 9.9 Yrs
Regional Practice Density
217 Specialists

Practicing in Reno, NV (5588 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Rehabilitation Practitioner Primary Specialty

NUCC Taxonomy Code: 225400000X

A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

22 Associated Practitioners
Cherylyn Wood

Social Worker

NPI 1013439306
Sara Daly

Social Worker

NPI 1073036059
Angelica West

Rehabilitation Practitioner

NPI 1083019244
Brian Dixon

Rehabilitation Practitioner

NPI 1093261356
Anel Contreras-Serrano

Behavior Technician

NPI 1144830043
Alyssa Fajayan

Social Worker

NPI 1154774479

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated October 30, 2025

Record deactivated on October 30, 2025

NPI Profile Active September 29, 2016

NPI status registered as active in NPPES database

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Updated Practice Location September 29, 2016

Registered at 4600 KIEZKE LANE, O-260, RENO, NV 89502 (Tel: 7758259995)

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Updated Business Mailing Address September 29, 2016

Registered at PO BOX 554, GREENVILLE, CA 959470554 (Tel: 5302847007)

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Provider Name / Credentials Updated September 29, 2016

Recorded as EDITH JOHNSON

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Medical Taxonomy / Specialty Registered (Primary Specialty) September 29, 2016

Rehabilitation Practitioner

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Initial NPI Registration & Enumeration September 29, 2016

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1396294484
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 29, 2016
Last Update: September 29, 2016
Deactivation Date: October 30, 2025

Mailing Address

Po Box 554

Greenville, CA 959470554

Phone: 5302847007

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.